A laparoscopic instrument comprises a handle, an outer sheath, and an insert. The outer sheath may be fixed to or alternately detachable from the handle. The insert extends through the sheath and is operatively coupled to the handle. The handle has two finger rings similar to a regular pair of scissors. When the handle is manipulated by squeezing together the finger rings or pushing them apart the insert is moved linearly relative to the outer sheath. The insert is provided at its distal end with an integrated tool. Linear motion of the insert relative to the sheath operates the tool. This may be manifested for example by the opening and closing of jaws or blades of the tool. The function and nature of this tool determines the type of insert. Types of inserts include scissors, dissectors, forceps and needle holders. Moreover, there are many variations within each type of insert. For example, scissor inserts are available as straight, curved, fine, parrot beak, serrated, single or double action scissor inserts. Dissector inserts are available as duck bill, Maryland, round nose, bottle nose, and mixter.
Depending on the type of laparoscopic surgery at hand, a surgeon will require a large range of laparoscopic instruments with specific inserts.
Also, while there are currently many different types of inserts available, some of these inserts require very high levels of surgical expertise and competence in order to avoid accidental injury to patients. Indeed the level of expertise required while maintaining patient safety may at times be beyond many surgeons.